Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research Does Enhanced School-Readiness Affect Adult Health of African Americans? This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Enhanced school readiness is one preventive intervention that might impact health in adults. This application is to follow-up participants in two randomized trials of early childhood educational intervention for children born into poverty. Long-term follow-up data on these samples provide a unique opportunity to learn the extent to which early educational interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on later life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. The Abecedarian Project and the Carolina Approach to Responsive Education (CARE) were consecutive early childhood programs carried out at the Frank Porter Graham Child Development Institute. Between them, 177 infants (93.8% African American) were enrolled and randomly assigned to early treatment or to control conditions. At age 21, 92.6% of the original sample was successfully followed up. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined. PUBLIC HEALTH RELEVANCE: Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Our randomized trials of early childhood educational intervention for children born into poverty qualify as interventions that address these determinants, and our long-term follow-up data provide a unique opportunity to learn the extent to which such interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on their chances for life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. Two randomized controlled trials of early childhood educational intervention were established at the Frank Porter Graham Child Development Institute (then "Center") in the 1970s. The Abecedarian project (ABC) randomly assigned 111 infants born into low income families either to an educational intervention program delivered in a full-time child care setting or to an untreated control group. Treatment lasted until kindergarten entry at age 5. Four cohorts of infants were enrolled between 1972 and 1977. The Carolina Approach to Responsive Education study (CARE) followed immediately, enrolling 66 infants in 1978-1980. CARE modified the full time child care treatment by adding to it Home Education (home visits) for parents. A second treatment model provided the Home Education program alone;CARE also had a randomly assigned control group. Thus, an intent-to-treat analysis of later findings allows for comparisons among 5 groups, but the primary question concerns the difference in outcomes between the combined ABC and CARE groups who received the child care based educational intervention compared with the combined ABC and CARE controls. Early childhood results showed that children who had the child care based early intervention earned higher scores on cognitive tests during the preschool years, and those in t he ABC study earned higher scores on academic measures (reading and mathematics). Followed up as young adults, those with child care based treatment in both ABC and CARE had higher levels of education, were more likely to attend college, and more likely to be working at a skilled job compared with the controls. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined.